Fozard Julia, Pandya Nikila, Pulikot Ashok, Fish David, Malhotra Raman, Lake Damian
Department of Paediatrics, Maidstone Hospital, Dagenham, UK.
BMJ Case Rep. 2011 Aug 17;2011:bcr0720114508. doi: 10.1136/bcr.07.2011.4508.
A 12-year-old girl presented with a 1 week history of orbital swelling associated with granuloma, purulent discharge from the eye and preauricular and submandibular lymphadenopathy. Initial conventional treatment for presumed preseptal cellulitis was unsuccessful. Despite treatment with broad spectrum antibiotics, the preseptal cellulitis progressed to orbital cellulitis with restriction of eye movements in addition to the marked conjunctival chemosis and haemorrhage. A detailed history revealed she had been in close contact with newborn kittens at home and biopsy of the granuloma demonstrated Bartonella species, confirming the diagnosis of cat scratch disease. The child received a course of appropriate oral and topical antibiotics and steroids. Unfortunately eyesight in the right eye remains poor on follow-up.
一名12岁女孩出现眼眶肿胀1周，伴有肉芽肿、眼脓性分泌物及耳前和颌下淋巴结肿大。最初针对疑似睑前蜂窝织炎的常规治疗未成功。尽管使用了广谱抗生素，睑前蜂窝织炎仍进展为眼眶蜂窝织炎，除了明显的结膜水肿和出血外，还伴有眼球运动受限。详细病史显示她在家中与新生小猫密切接触，肉芽肿活检显示为巴尔通体属，确诊为猫抓病。该患儿接受了一个疗程的适当口服和局部抗生素及类固醇治疗。遗憾的是，随访时右眼视力仍较差。
